Kornimate/medical-research-clean huggingface dataset:
intensive care unit (icu) admission decisions in the elderly : the ice-cub study

Conditions: Patient Admission; Death; Activities of Daily Living

Summary: percentage of patients over 80 admitted in icu varies greatly from one center to another. icu admission criteria of older patients are scarcely described and benefit of icu admission for those patients is uncertain. in this study, we prospectively studied old patients arriving to the emergency department of 15 french hospitals with conditions that potentially warrant icu admission.the working hypothesis was that icu admission was associated with a 20% decrease in six-month mortality.

this was a prospective multicenter observational cohort study of elderly individuals presenting to one of 15 emergency departments and possibly qualifying for admission to an icu. to be included, subjects had to be aged at least 80 years and be diagnosed by the ed physician with one of 74 conditions potentially warranting icu admission.outcome studied are icu eligibility as assessed by emergency and icu physicians, hospital and six-month death and changes in functional status in the six month following emergency department visit.

Eligibility criteria:
inclusion criteria: * age over 80 * be assigned by the emergency physician with one of 74 conditions potentially warranting icu admission exclusion criteria: * patient's refusal

Keywords: intensive care units triage aged, 80 and over death activities of daily living health services research health care quality, access, and evaluation
blood collection study from covid-19 convalescents previously hospitalized to identify immunogenic viral epitopes

Conditions: Identify the Viral Epitopes of Memory CD8 T Cells From Individuals That Have Recovered From SARS-CoV-2 Infection; Determine Which SARS-CoV-2 Proteins Are Frequently Recognized by T Cells in Patients With Varying HLA Types

Summary: the covid-19 pandemic is a global emergency threatening to take millions of lives in the united states and around the world. there is no current vaccine strategy against covid-19 infection caused by a novel coronavirus named sars-cov-2. studies with a related coronavirus called sars-cov-1 that caused the sars outbreak in 2003 indicated that memory cd8+ t cells recognizing viral epitopes persisted for more than 6 years post infection while neutralizing antibodies and memory b cells were short-lived and were undetectable after a short period of time (tang et al., 2011; peng et al., 2006; channappanavar et al., 2014). thus, including viral epitopes that are recognized by memory cd8+ t cells is imperative for vaccines that can provide long-term immunity against sars-cov-2. in this study, blood samples from covid-19 patients who have recovered from the infection will be used to identify the viral epitopes recognized by their memory cd8+ t cells. this will be accomplished using a genome-wide, high-throughput screening technology developed at harvard medical school (kula et al., 2019) and licensed by the study sponsor, tscan therapeutics. a 24,000-member library that tiles across all \~100 viral isolates of sars-cov-2 that have been sequenced so far has already been synthesized at tscan. blood samples from convalescent patients are urgently needed to identify t cell receptors and immunogenic viral epitopes on sars-cov-2. it is the hope that these data will inform development of a vaccine with the potential for long-lasting protection against sars-cov-2.


Eligibility criteria:
inclusion criteria: * laboratory-confirmed diagnosis of covid-19 performed by the centers for disease control and prevention (cdc) at a hospital using an fda emergency use authorized molecular assay for covid-19 * age =\>18 years at time of diagnosis of covid-19 * time since discontinuation of isolation of =\>14 day following cdc criteria * ability to understand and willingness to sign an informed consent document * no anti-pyretic use for =\>17 days * ability to undergo blood draw for 4 tubes of blood containing approximately 7.5 ml of blood each * ability to travel to an assigned lab for blood draw * ability to waive any claim to blood samples or data obtained for this study's purpose exclusion criteria: * any serious medical or psychiatric disorder that would interfere with the subject's safety * dementia, altered mental status, or any psychiatric condition that would prohibit the understanding or rendering of informed consent * known blood disorder that would increase the risk of infection or bleeding from a simple phlebotomy
effects of exercise therapy on pectus carinatum

Conditions: Pectus Carinatum

Summary: pectus carinatum (pc); deformity in which the front wall of the chest protrudes forward. non-invasive treatment approaches for pc include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. in addition, the formation of muscles can help close the deformity. although exercise training is recommended, there is no randomized study showing its effectiveness in the literature. therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.

a chest wall deformity is a structural abnormality of the chest that can range from mild to severe. chest wall deformities occur when the cartilage that connects the ribs grows unevenly. it is not clear why this happens, but the condition tends to run in families. the two most common types of chest wall deformity are pectus excavatum and pectus carinatum, pectus carinatum goes far beyond a simple esthetical problem. it can be responsible of physical signs and symptoms and also has significant psychological impact. defects tend to worsen during pubertal growth spurts and even during adult life. recent evidence shows that these patients are at risk for a disturbed body image and reduced quality of life and many patients refer feelings of discomfort, shame, shyness, anxiety, anguish, and even depression, which can lead to social isolation. chest pain or discomfort, especially when lying in prone position, intolerance to physical exercise, scoliosis, impaired shoulders and kyphotic position are some of the physical signs and symptoms.non-invasive treatment approaches for pc include compression orthosis and exercises that target the deformity itself and concurrent postural impairment and scoliosis. in addition, the formation of muscles can help close the deformity. most evidence of non-invasive treatment is retrospective or prospective case series. in a prospective case series, patients were instructed to perform chest wall strengthening exercises, but the effects of the exercises were not investigated . although, exercise training is recommended, there is no randomized study showing its effectiveness in the literature. therefore, in our study, the investigators aimed to investigate the effectiveness of exercise therapy in addition to compression orthotics.

Eligibility criteria:
inclusion criteria: * patients diagnosed with pc by doctor and indicated for the first time orthotic use * a correction pressure of less than 10 pounds per square inch in the compression test * 10-18 years old, * discontented with this deformity exclusion criteria: * previous orthosis use * severe scoliosis (cobb angle above 20 degrees) * having chronic systemic disease * having serious psychiatric illness * having complex mixed pectus deformity

Keywords: pectus carinatum orthosis exercise
pentasa once daily in ulcerative colitis for maintenance of remission

Conditions: Ulcerative Colitis

Summary: this is a multi-centre, randomised, controlled, investigator blinded study. the randomisation will be done centrally. the patients will be treated for 1 year, with clinical and laboratory assessments at 0, 4, 8 and 12 months. endoscopic examination is at enrollment and on completion of the study (at relapse or after 12 months). number of subjects (planned and analysed): * 360 patients for demonstration of non-inferiority between once daily and twice daily; * 326 to be analysed in per-protocol (pp) analyses; and * 360 in intention-to-treat (itt) analyses.


Eligibility criteria:
inclusion criteria: 1. patients have an established diagnosis of ulcerative colitis and are in clinical remission with an uc-dai \< 2 at enrollment 2. extension of the disease \> 15 cm distance from anal verge 3. patients who have had a clinical relapse within the past year. clinical relapse is defined as activity of the disease for which maintenance therapy had to be adjusted. 4. patients on oral mesalazine maintenance therapy ≤ 2.5 grams per day 5. 18 years or older 6. signed informed consent exclusion criteria: 1. patients with evidence of other forms of inflammatory bowel disease, idiopathic proctitis or infectious disease 2. patients allergic to acetylsalicylic acid and other salicylate derivates aspirin or salicylates derivatives 3. patients who used mesalazine \> 2.5 grams orally in the previous month, 4. patients who used rectal mesalazine \> 3 grams per week in the previous month 5. use of corticosteroids (oral and/or rectal routes) within the last month 6. intake of immunosuppressants within the last 3 months 7. patients with (known) significant hepatic (up to 2 x upper limit of normal) or (known) renal function abnormalities, to 1.5 x upper limit of normal values 8. patients with history or physical examination findings indicative of active alcohol or drug abuse 9. patients with a history of disease, including mental/emotional disorders, that would interfere with their participation in the study 10. women who are pregnant or nursing (non-menopausal women who are sexually active and do not use effective contraceptives, as judged by the investigator, must have a negative pregnancy test) 11. patients who participated in another clinical study in the last 3 months 12. patients who were previously participating in this study 13. patients with any other disease that may influence the study assessment, such as malignant disease, etc. 14. patients who are unable to comply with any requirements of the protocol 15. patients who are unable to write or read local language.

Keywords: ulcerative colitis for maintenance of remission
hfnc alone or associated with niv for immunocompromised patients admitted to icu for acute respiratory failure

Conditions: Acute Respiratory Failure; Immunosuppression

Summary: acute respiratory failure is the leading cause of icu admission of immunocompromized patients. in this subgroup of patients, the need for intubation and invasive mechanical ventilation occurs in about 50% of cases and is associated with very a high mortality rate, reaching 70% of cases. therefore, noninvasive oxygenation strategies have been developed to avoid intubation. more than 15 years ago, 2 trials have suggested that niv could decrease intubation and mortality rates of immunocompromized patients as compared to standard oxygen through a mask. however these results have not been confirmed in a recent large trial. hfnc is a recent and well-tolerated oxygenation technique. in a recent trial, hfnc alone could decrease mortality and intubation rates in patients with arf as compared to niv. similar findings have been reported in a post-hoc analysis on immunocompromized patients excluding those with profound neutropenia. likewise in a retrospective monocentric cohort of immunocompromized patients, we reported better outcomes with hfnc than with niv.


Eligibility criteria:
inclusion criteria: * age ≥ 18 * admission to icu for acute respiratory failure defined by all of the following criteria: * dyspnea at rest with rr ≥ 25 breaths/min * paco2 ≤ 50 mm hg * pao2/fio2 ≤ 300 mm hg under oxygen ≥ 10 l/min through a mask or hfnc or niv (for patients under oxygen fio2 will be calculated using the following formula: oxygen flow in liters per minute x 3 + 21) * immunosuppresion defined by 1 of the following criteria: * hematological malignancy (active or remitting \< 5 years) * allogenic stem cell transplantation \< 5 years * solid cancer (active) * leucopenia \< 1 g/l or neutropenia ≤ 0.5 g/l after chemotherapy * solid organ transplantation * aids (not only hiv) * treatment with immunosuppressive or immunomodulatory drugs * systemic steroids ≥ 0.5 mg/kg/d of prednisone-equivalent for ≥ 3 weeks * non opposition to participate obtained from the patient or their legally acceptable representative. exclusion criteria: * contraindication of niv (patient refusal, cardiac arrest, coma, not drained pneumothorax, unresolving vomiting, upper airways obstruction, hematemesis, severe facial trauma) * chronic respiratory failure with altered pulmonary function tests * overt cardiogenic pulmonary edema * urgent need for intubation * severe shock (vasopressors \> 0.3 µg/kg/min to maintain sap \> 90 mm hg) * impaired consciousness (glasgow coma scale score ≤ 12) or agitation * surgery under general anesthesia \< 7 days * previously included in the trial * do-not-intubate order * pregnancy or breastfeeding * persons benefiting from enhanced protection, namely minors, persons deprived of their liberty by a judicial or administrative decision, persons staying in a health or social institution, adults under legal protection
percutaneous treatment of tricuspid valve regurgitation with the tricinch system™

Conditions: Tricuspid Regurgitation

Summary: the tricinch system™ is intended for percutaneous treatment of tricuspid regurgitation. it is a percutaneous catheter-based device designed for tricuspid valve repair in order to decrease effective cross-sectional area and relieve symptoms in patients with tricuspid valve regurgitation.

implantation procedure: unlike the standard open chest, arrested heart approach, the 4tech tricinch system™ provides a percutaneous solution for tricuspid valve regurgitation treatment: this procedure is performed through deep sedation, while the heart is beating, without the need for respiratory assistance. the tricinch system™ consists of a delivery system that enables transcatheter placement of an implant that can be adjusted to correct tricuspid valve regurgitation. the tricinch delivery system is inserted from the femoral vein to access the right atrium of the heart. at the end of the correction process, the tricinch delivery system and the venous introducer are removed and the procedure is concluded.

Eligibility criteria:
inclusion criteria: * functional symptomatic tricuspid regurgitation (tr) 2+ to 4+ on a scale of 4+ (moderate to severe), with annular dilatation greater than 40mm. * signed informed consent form prior to any study-related procedure. * available and able to return to the study site for post-procedural follow-up examination * eighteen (18) years of age or older. exclusion criteria: * requirement for concomitant cardiac procedure (other than atrial fibrillation correction surgery, closure of pfo (patent foramen ovale) or asd (atrial septal defect), or ptca (percutaneous treatment of coronary artery) or cad (coronary artery bypass surgery) from 1 to 3 months after or before other procedure. * presence of any known life threatening (non-cardiac major or progressive disease), non-cardiac disease that will limit the subject's life expectancy to less than one year. * cerebro-vascular event within the past 6 months. * history of mitral/tricuspid endocarditis within the last 12 months. * organic tricuspid disease. * contraindication or known allergy to device's components, aspirin, anti-coagulation therapy or contrast media that cannot be adequately premeditated. * severe hypertension (sbp ≥ 180 mmhg and/or dbp ≥ 110 mmhg, measurement done by sphygmomanometer with stethoscope, allow the patient to sit for at least 5 minutes before beginning bp measurements). * female patient is pregnant (urine hcg test result positive) or lactating. * known alcohol or drug abuser. * currently participating in the study of an investigational drug or device. * at heart team's judgement, patient ivc dimension is not adequate for device implantation.

Keywords: tricuspid regurgitation repair outcomes
cloxacillin as prevention of double lumen infection in hemodialysis patients

Conditions: Double Lumen Infection; Hemodialysis

Summary: the purpose of this study is to investigate whether cloxacillin lock is effective in prevention of double lumen infection.

double lumen infection is one of the causes of morbidity and mortality in hemodialysis patients. many strategies used to prevent it and one of them is antibiotic lock. thus we select chronic hemodialysis patients and divided them into 2 groups. one group received cloxacillin and heparin as catheter lock and the second group received only heparin lock.

Eligibility criteria:
inclusion criteria: * hemodialysis for 3 months * at least 2 time dialysis/week exclusion criteria: * active infection * acute renal failure
efficacy of a dedicated therapeutic education program in patients at high cardiovascular risk

Conditions: High Blood Pressure

Summary: a dedicated therapeutic education program is an essential tool in the management of hypertension as well as in the control of other cardiovascular risk factors. the purpose of this study is therefore to evaluate the effect of such a therapeutic education program in general practice patients at high cardiovascular risk.

current guidelines for the prevention of cardiovascular disease recognize the major interest of an optimal control of all cardiovascular risk factors. it includes high blood pressure reduction, dietetic measures (weight loss - control of dyslipidemia and diabetes - regular physical activity), smoking cessation, stress management, ... in that way, some authors suggest that it is essential for patients at high risk to have knowledge about their own pathology, medication, and to better understand the real benefit of specific lifestyle behaviors and the importance of blood pressure and glycaemia surveillance ... the aim of this randomized controlled trial is to evaluate the efficacy of a dedicated therapeutic education program to control blood pressure and other cardiovascular risk factors in general practice patients at high cardiovascular risk. 250 patients are being enrolled. all patients will receive standard care but only 125 patients (randomized 1 to 1) will receive a structured therapeutic education program.

Eligibility criteria:
inclusion criteria: * man or woman of more than 18 years with a health insurance policy * general practice patients who are agree to participate of the program of patient's therapeutic education in lille (59) or arras (62) * written informed consent must be obtained prior to performing any study-specific procedures * patient at high cardiovascular risk (patient with a high blood pressure and 3 cardiovascular risk factors and/or patient with cardiovascular disease) exclusion criteria: * patient unwilling to take part to the therapeutic education program or to the study * patient not suitable to participate in the therapeutic education program * patient with dementia * anticipated survival (due to comorbidities) of less than one year from baseline * patient with current addiction or current alcohol / drug abuse * patient with known plans to move to another area of the country * unable to obtain written informed consent * patient who are pregnant or lactating * person without liberty by administrative or judiciary decision

Keywords: cardiovascular risk, therapeutic education, general practice
endoscopic extirpation of benign breast tumors using a lateral chest wall incision

Conditions: Endoscopic Breast Surgery; Benign Breast Tumors

Summary: 1. a new surgical method for breast surgery has been introduced, which involves the removal of benign breast tumors through endoscopic surgery, thereby avoiding noticeable scarring on the breast. 2. the feasibility of this surgery, key technical points, and potential complications have been analyzed.


Eligibility criteria:
inclusion criteria: 1. female breast benign tumor patients 2. received endoscopic resection of benign breast tumors via a lateral chest wall approach. exclusion criteria: 1. patients who are unable to comply with follow-up requirements 2. patients with a history of breast sugery 3. breast cancer patients
fetal cardiac function evaluation with acmq-strain fetal (strain)

Conditions: Fetal Cardiac Disorder

Summary: to assess whether the acqm-strain ultrasound method allows a good analysis of fetal cardiac function. establish normality parameters and compare it with fetuses with risk factors of cardiac dysfunction.

national unicentric observational study of follow-up study of a cohort. it has been decided to conduct a study of consecutive cases, including all patients who meet the inclusion criteria during the time of the study. until now, there has not been an easy and convenient method to determine fetal cardiac function. recently a new software (automated cardiac motion quantification acmq) has been developed, and it seems that allows an easier analysis of this one. this study aims to analyze fetal heart function with the strain method in healthy patients and then compare it with fetuses with risk factors for cardiac dysfunction. initially, healthy pregnant patients who agree to participate in the study will be cited, after signing the informed consent, in order to evaluate the normal fetal cardiac function and see how it is modified in the different weeks of gestation. to do this, a fetal echocardiography will be performed by the investigators at week 24, 28, 32 and 36 of pregnancy, using the acmq-strain method. once the investigators have established normality curves, fetuses with risk factors for cardiac dysfunction of women who agree to participate in the study will be analyzed. for this purpose, a fetal echocardiography at week 24, 28, 32 and 36 of gestation, using the acmq-strain method will be performed. all tests will be carried out in the same study center and will be carried out by independent scouts.the data obtained in each test will be collected in an anonymized database for further study.

Eligibility criteria:
inclusion criteria: * patients older than 18 years * pregnant women\> 20 weeks gestation * understand and accept the study procedures and sign an informed consent. exclusion criteria: * not being able to understand the nature of the study and / or the procedures to be followed. * not signing informed consent * under 18 years of age * not pregnant

Keywords: cardiac function fetal strain